The pluralistic framework builds on pre-existing integrative approaches

By John Mcleod

The pluralistic model can be viewed as a kind of meta-perspective or meta-theory. There already exist many therapy theories/approaches (e.g., CBT, psychodynamic, person-centred, etc). A pluralistic framework offers a navigation system for finding a way through these existing models. For anyone new to pluralistic practice, it can be useful to think about what kind of navigation system you already had, based on your previous training and experience, and how a pluralistic system either built on that or was in conflict with it.

The main strategies used by therapists for integrating theories, ideas, interventions, etc from different sources, tend to be either personal intuition and/or some kind of assessment of client need. Other integrative strategies that exist in the broader professional literature are based on: using different skills/interventions at different stages of therapy (e.g., like the Egan model); developing a new theoretical model that incorporated bits of other models (Emotion Focused Therapy is an example of that, but quite a lot of therapists also seem to have evolved their own personal integrative theories); or being explicitly guided by what the research evidence suggests is best for each client.

I think that it is really important, if you are moving in the direction of pluralism, to be aware of your pre-existing approach to combining therapy ideas/interventions. Basically, a pluralistic approach builds on any of the previous approaches outlined in the previous paragraph, but adds in the key ingredient of sharing this knowledge with the client, in a way that takes account of the client’s own ideas and opens up a process of shared decision-making. To be able to do this, you need to be able to articulate and explain your own position. If you are unable or unwilling to ‘show your workings’ then the client cannot see where you are coming from, and there is a risk that you will be seen by the client as operating from a dominant ‘expert’ position that leaves little space for their active involvement in shared decision-making. For example, if you come up with some ideas about how therapy should proceed, by assessing client need, it is surely useful to check out with a client whether your analysis of their needs (and the proposed remedies) make sense to them.

John McLeod
February 2019